Assessment of Intra-operative and Early Post-operative Complications of Laser in–situ Keratomileusis

Abstract

Several Laser in-situ keratomileusis (LASIK) complications have been identified over the years. Reporting complications of LASIK surgery will help refine the approach to their management. LASIK was introduced in the late 1980s with the development of the ophthalmic excimer laser [1,2]. To avoid the disadvantages of photorefractive keratectomy (PRK), LASIK was introduced [3]. LASIK rapidly increased in popularity and became the predominant form of refractive surgery in the late 1990s and continues till today [4]. Correcting different refractive errors, including myopia, hyperopia, and astigmatism, is the main aim of all laser refractive procedures. LASIK has been used to treat many degrees of myopia with promising results, and there are great expectations for treating farsightedness. Compared to PRK, LASIK is advantageous in causing minimal postoperative discomfort, rapid restoration of visual clarity and stability of refractive changes, less frequent opacification, and better ability to correct high levels of myopia. Intraoperative complications, although infrequent, include Microkeratome-related flap complications (flap buttonhole, free cap, and incomplete, short, or irregular flaps), corneal perforation, corneal epithelial defect, conjunctival bleeding, subconjunctival hemorrhage, and interface debris [6]. Post-operative Complications include inaccurate correction, visual aberrations, flap striae (macrostriae -microstriae) [6], flap dislocation, dry eye, diffuse lamellar keratitis (DLK), pressure-induced stromal keratitis (PISK), infectious keratitis [7], and epithelial ingrowth [8]. Aim of the Study: To assess incidences, possible aetiology of the intra-operative, and early post-operative complications of LASIK. Literature-based Methodology: The intra-operative complication rate, reported between 0.7% and 6.5% [6], is most commonly associated with flap-related issues, including mechanical or FS Laser complications. Ethical Consideration: The study was approved by the Ethical Committee at the Faculty of Medicine, Assiut University (IRB No.17101184).